Seborrheic eczema is a chronic type of dermatosis, which is manifested by rashes in the form of small nodules. Over time, such nodules form plaques, covered with dense and greasy scales. If you remove such scales and crusts, then a wet surface will open. Rashes are usually localized behind the auricles, in the area of the head and face, on the skin folds, in the umbilical region, as well as on the skin of the trunk and on the flexor surface of the limbs.
The content of the article:
Causes of seborrheic eczema
Symptoms of seborrheic eczema
Diagnosis of seborrheic eczema
Treatment of seborrheic eczema
Seborrheic eczema
Diagnostics includes dermatoscopy, taking a scrape for pathogenic fungi, consulting various specialists, examining the organs of the gastrointestinal tract, studying the hormonal status. Treatment is usually carried out through local antimicrobials, vitamins and physiotherapy methods.
Seborrheic eczema is considered a clinical form of eczema, which includes true, professional, microbial eczema. The disease occurs in persons of both sexes and at any age. Very often, seborrheic eczema will form against the background of seborrhea or as seborrheic dermatitis. In HIV carriers, seborrheic eczema can become a manifestation of AIDS. A feature of eczema is its spread throughout the skin.
Causes of seborrheic eczema
In modern dermatology, they talk about the infectious-allergic theory of the development of seborrheic eczema. In clinical studies, in 50% of cases of seborrheic eczema, Pityrosporum ovale is present in the lesion itself. Candida fungi (or staphylococci) are usually detected less frequently.
Factors that are considered precursors of the development of seborrheic eczema are an increased level of secretion production (sebaceous glands), gastrointestinal diseases (ulcers, gastritis), liver dysfunction (cirrhosis, hepatitis), hormonal disorders (obesity, diabetes mellitus, estrogen imbalance, for example), VSD. Very often, seborrheic eczema occurs against the background of reduced immunity, which is caused by acute respiratory infections, chronic infections (sinusitis, sinusitis), severe diseases.
Symptoms of seborrheic eczema
The first stage of the development of seborrheic eczema begins with the formation of pink-yellow nodules on the skin. Such nodules are small in size. Gradually, such nodules may increase or merge, which in the future will lead to the appearance of infiltrated disc-shaped plaques. Such plaques reach a diameter of 1-2 cm and are covered with multiple dense scales, which are also greasy.
When trying to remove the scales, the opening surface becomes wet. The lesions have uneven edges and clear boundaries. At the very beginning, they may be dry or, on the contrary, presented with a “greasy” look. The accompanying itching is not pronounced clearly and rarely bothers patients. The resolution of the elements begins from the very center of the hearth and further leads to the process of transformation of plaques into arcs or rings. If the right therapy is carried out, then later there will not be a single trace on the skin.
As a rule, rashes of seborrheic eczema are located in the head area (in the area of hair growth, eyebrows, nasolabial fold, near the mouth, behind the ears). If the foci of seborrheic eczema are localized on the scalp, growing along the periphery, they tend to move to the hairline, affecting the forehead. The lesion is usually well-defined by an infiltrated border of reddish color, resembling a psoriatic disk. This symptom is called “seborrheic crown”. From the back of the head, from its hairy part, the rash of seborrheic eczema penetrates the neck and into the ear folds. When the rashes merge, they form an extensive lesion in the form of a helmet — an “eczematous helmet”.
During the course of seborrheic eczema, skin lesions with the formation of blepharitis are often observed. Usually blepharitis is characterized by pronounced puffiness and red color, as well as the presence of scales and the appearance of cracks near the outer edge of the eye. Damage to the eyelids is most often combined with conjunctivitis and proceeds in parallel with the discharge from the eyes, which is why they stick together in the morning.
Seborrheic eczema of smooth skin is concentrated in the chest area, as well as in the umbilical or interscapular areas. It is possible that seborrheic eczema is located in the armpits and on the flexor surface of the limbs. Due to the uneven edges, the lesion of the smooth skin surface may resemble a geographical map. Usually such lesions rise slightly above the general level and are prone to peripheral growth.
It is possible that seborrheic eczema is complicated by infection of rash elements with the further appearance of folliculitis, ostiofolliculitis and hydradenitis.
Diagnosis of seborrheic eczema
The diagnosis of seborrheic eczema is usually made by a dermatologist. Usually, to make a diagnosis, it is enough to conduct an external examination of the lesion of the dermis itself. Dermatoscopy is also performed, skin and hair scraping is taken for the presence of pathogenic fungi. Luminescent diagnostics is also possible. Secondary infection will serve as a signal to carry out back-sowing of secretions from the hearth.
With the help of histological examination during seborrheic eczema, hyperkeratosis can be detected, as well as a mild degree of acanthosis and intracellular edema. The elongation of epidermal outgrowths is also determined by this study. The latter is also observed in neurodermatitis. A distinctive feature is the presence of accumulated lipids located in the upper layers of the epidermis. The presence of coccoid flora, symptoms of perifolliculitis — all this can also be diagnosed.
In order to identify other background diseases and symptoms of chronic diseases, people suffering from seborrheic eczema are prescribed advice from other specialists — an endocrinologist, gynecologist, neurologist, gastroenterologist. For the same purpose, other studies are carried out: ultrasound of the peritoneum, gastroscopy, hormonal studies, pelvic ultrasound, pharyngoscopy and rhinoscopy. Patients whose eyelids are affected need to consult an optometrist.
Differential diagnosis of seborrheic eczema should be carried out with psoriasis, professional true eczema, microscopy and trichophytia. Localization of rashes on the head, as well as the absence of harmful effects in the anamnesis, which are associated with the professional activity of the patient, will allow to exclude the professional nature of the disease.
As is known, with seborrheic eczema, the clinical symptoms are more monomorphic: there are no vesicular rashes, as well as associated wetness. The presence of not very dense plaques and small scales, as well as elements on the flexor surface of the arms and legs, helps to distinguish this type of eczema from psoriasis, for example.
If we talk about microscopy and trichophytosis of the scalp, then it will be characterized by hair changes in the form of peeling and the release of mycelium of fungi during hair examination.
Treatment of seborrheic eczema
Patients who have an increased degree of sebum secretion should limit the consumption of fatty and sweet foods, as well as temporarily stop visiting baths, staying in hot places and humid hot climates. With this disease, you should carefully select the products intended for hair and skin care. Such products should fully correspond to the patient’s hair type and the fat content of his skin.
Local treatment of seborrheic eczema
If we talk about the local treatment of seborrheic eczema, then it is carried out using antimicrobial agents, which include sulfur-resorcinol and white mercury ointment, salicylic ointment and sulfur talker. Inside, the use of riboflavin and vitamins B1 and B6 is prescribed. One of the following physiotherapeutic methods can have a beneficial effect in treatment: darsonvalization, laser treatment, magnetotherapy, cryotherapy, cryomassage. If a secondary infection joins the main disease, then the use of antibacterial ointments and other antibiotics will be required.
It is important to know that the treatment of seborrheic eczema is carried out together with the therapy of the background disease, as well as with the rehabilitation of infectious foci.
